Imaging Markers for Normal Pressure Hydrocephalus: An Overview

Abstract

Idiopathic bormal pressure hydrocephalus (iNPH) is a neurological syndrome that clinically presents with Hakim’s triad, namely cognitive impairment, gait disturbances, and urinary incontinence. The fact that iNPH is potentially reversible makes its accurate and early diagnosis of paramount importance. Its main imaging characteristic is the dilation of the brain’s ventricular system and the imaging parameters are also included in its diagnostic criteria along with clinical data. There is a variety of different modalities used and a great number of imaging markers that have been described while assessing iNPH patients. The present literature review attempts to describe the most important of these imaging markers and to shed some light on their role in diagnosis, differential diagnosis, and possibly prognosis of this potentially reversible neurological syndrome.

Assessing CT-based Volumetric Analysis via Transfer Learning with MRI and Manual Labels for Idiopathic Normal Pressure Hydrocephalus

“…Computed tomography (CT) scans are the major routine method for evaluating brain morphology in both developed and developing countries but typically rely on subjective visual inspection and ratings 43,44 . Adopting reliable automated and quantitative methods, such as machine learning for ventricular segmentation, could substantially improve the diagnostic performance of CT-derived data through enhanced accuracy and consistency, reducing inter-rater variability, and providing substantial benefits in both research and clinical contexts.…”

Chronic Disorders of Consciousness: guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists”

“…Вентрикуломегалия, выявляемая методами нейро визуализации, может быть следствием атрофии или гидроцефалии. Гидроцефалия может блокировать восстановление сознания, а ликворошунтирующие операции могут способствовать процессам его восстановления [122][123][124][125].…”

Improve the diagnosis of idiopathic normal pressure hydrocephalus by combining abnormal cortical thickness and ventricular morphometry

“…These studies underscore that two-dimensional ventricular morphometry for quantifying ventricular enlargement is nonspecific and insufficient as independent diagnostic or prognostic indicators for iNPH. Moreover, it fails to explain the typical triad symptoms of iNPH patients ( Espay et al, 2017 ; Mantovani et al, 2020 ; Pyrgelis et al, 2023 ).…”

“…It has been widely applied in studying the structural characteristics of the brain in various neurodegenerative diseases (Hutton et al, 2008;Kang et al, 2018). Previous researches in animal models and children with hydrocephalus has reported an association between increasing ventriculomegaly and more marked thinning of the cerebral cortex (Olopade et al, 2012;Pyrgelis et al, 2023). A study revealed that total cortical thickness was thinner in the iNPH group compared with the control group (Moore et al, 2012).…”